A surgeon wrote a scathing letter to Western Health officials last year linking the death of a patient to an "unsafe" surgical services situation in Stephenville.
But the health authority says there has been "a full disclosure process with families involved here," and the families expressed thanks for their honesty and openness.
Surgeons have continued to complain about the setup, but Western Health contends that safety is not an issue and many of the concerns have been addressed.
The Telegram obtained the 2007 correspondence from the surgeon to Western Health under provincial freedom-of-information laws.
"In just one month of work I have already experienced several terrible situations resulting from general surgery presence in Stephenville. The worst scenario so far involved the ..."
The next two lines of the letter are blacked out, for privacy reasons.
"Unfortunately, the diagnosis of (words blacked out) was unknown prior to her transfer to Corner Brook. We did our best to save her life with emergent surgery, but she is now dead. I will state plainly and confidently that she would have stood a substantially greater chance of still being alive today had she been initially assessed by surgical services at Western Memorial Hospital."
The name of the surgeon who wrote the letter - addressed to Western Health officials and dated Jan. 2, 2007 - was also blacked out in documents provided to The Telegram.
Dr. Ken Jenkins, vice-president of medical services with Western Health, said the authority was "totally open and transparent" regarding this situation.
He said they shared with family members the concern of surgeons and the findings of an independent review.
The health authority is not facing any legal action, Jenkins said, and, in fact, has received thanks from the families, who lauded the authority's honesty and openness.
In the 2007 letter, the unnamed surgeon warned of possible legal ramifications related to the Stephenville setup.
"I am writing to officially notify you, and the hospital administration, of my medical opinion on this issue: I feel the presence of surgical services in Stephenville is a danger to society." The last sentence is underlined in the original document.
The surgeon noted that the letter was aimed at "legally transfer(ing) the burden of responsibility and liability" up the chain of command.
"To state this plainly, the hospital administrators receiving this letter can/will now be sued for patient mortality that results from their decision to keep surgical services open in Stephenville," the letter noted.
"History would certainly support the concern that letters such as this can end up in the wrong hands. While I feel media and patient/family exposure to the contents of this letter would be clumsy and damaging, it will get my full support if it appears to be the only mechanism for change. While patients continue to suffer, I will not allow this issue to smolder in the usual timeframe of administrative and political process.
"If this issue does explode into the mess it quite clearly could, I will be standing firmly behind my (Fellow of the Royal College of Surgeons of Canada) designation as a Canadian-trained and certified general surgeon expressing my medical opinion."
Newfoundland and Labrador Medical Association (NLMA) officials told The Telegram last month that doctors were worried about the safety of having a solo surgeon performing operations at Stephenville's Sir Thomas Roddick Hospital.
But Western Health said the situation is not a "danger to society," as the January 2007 letter charges.
"It's not wording that I would particularly utilize myself in terms of describing the concern," Jenkins said.
Jenkins said many of the issues identified in the 2007 letter have since been addressed. That includes the hiring of an anesthesiologist and two OB/GYNs, who will be starting in the fall. The authority is actively looking for a second surgeon to join the Stephenville staff.
A CT scanner is now operational, Jenkins noted, and the Stephenville surgeon is backed up by colleagues in Corner Brook and St. John's.
Western Health commissioned an external "quality assurance" review after receiving the letter last year.
A draft version of the so-called Heughan report was ready in June 2007, and released to doctors in February 2008.
A Feb. 25, 2008, letter sent to acting Western Health CEO Devon Goulding urged the health authority to "act promptly and responsibly on this matter."
Again, the identity of the letter writer or writers is blacked out.
A followup letter to top Western Health administrators, dated April 10, charged that the Stephenville surgical program "is continuing as if the Heughan report did not exist."
But Jenkins said those views would likely not be the same today.
"I would suggest to you that that opinion probably differs a bit right now as we're talking, as compared to then. I think what maybe they weren't happy about is (they) weren't necessarily seeing a formal response, so to speak, to that particular report. But we were doing a tremendous amount of work on very significantly related issues."
To see the letters written to Western Health click on the link below: